Male athletes are the group most likely to tear their Achilles tendon, according to a new study published in the April 2013 issue of Foot & Ankle International (FAI), A SAGE journal. The activity most likely to cause the injury was basketball, and NBA players such as Kobe Bryant have been in the news lately for this exact injury.

Drs. Steven Raikin, David Garras and Philip Krapchev reviewed 406 records from patients at one clinic diagnosed with Achilles tendon injuries from August 2000 and December 2010. The average age was 46 years old, 83% of the patients were males, and sports were responsible for 68% of the ruptures.

The most common sports involved were basketball (32% of all ruptures), tennis (9%), and football (8%). Among patients younger than 55 years of age, 77% of ruptures occurred during sports, compared to 42% of the patients 55 or older.

Older patients, and those whose BMI (body-mass index) was greater than 30, were more likely to have non-sports related causes and were more likely to not have been diagnosed correctly at the time of injury. Greater than one-third of the tendon ruptures not caused by sports occurred at work. When the diagnosis was missed, it was usually because the initial diagnosis was an ankle sprain.

"Delayed diagnosis and treatment have been shown to result in poorer outcomes," says Steven Raikin, MD, of the Rothman Institute in Philadelphia, PA, and American Orthopaedic Foot & Ankle Society (AOFAS) member. "Older individuals, and those with a higher BMI, should be evaluated carefully if they have lower leg pain or swelling in the Achilles tendon region."

Re-rupture of the same tendon occurred in 5% of the group, and 6% of the study's population had previously ruptured the other leg's tendon. The study supported previous findings that an Achilles tendon rupture on one leg increases the likelihood of a rupture on the other leg. When the same tendon was re-ruptured, 85% of those injuries had not been treated surgically earlier.